Find the entry point for the guide wire is one of the most crucial steps in antegrade intramedullary femoral nail placements. Guide wire positioning is usually done by trial and error method under C-arm image guidance. This method takes more time and does not give assurance of correct position of the entry point or trajection of the guide wire. It is always challenging to perform this guide wire positioning in minimum time with maximum accuracy.
Minimally invasive fracture fixation can be technically demanding, especially in body regions characterized by complex bony anatomy and the presence of a significant amount of soft tissue. Hence, this procedure is associated with a high risk of implant malposition. As a consequence, radiation exposure to the patient and the surgeon increases during surgery. Proximal femoral fractures are the second most common fracture in older patients and place a heavy demand on orthopedic departments worldwide. A short surgery time and use of less invasive approaches are the two key-parameters to reduce surgery related morbidity. In addition, an intramedullary nailing of proximal femoral fractures is often accompanied by increased radiation exposure time to control the implant placement [Chong K W, et al. Injury 2006; 37(8):755-762.]. The surgery should be least disruptive to the soft tissue envelope thus preserving blood supply and consequently better bone healing in poor quality osteoporotic bone. An added bonus will be to reduce the radiation exposure to the surgeon who is performing such operations on a regular basis.
A wide range of instruments could be subsumed from simple guiding drill sleeves to targeting tools adapted to the implant design [Krettek C, et al. Clinical Orthopedics and Related Research 1999; (364):267-275]. All of these devices are used to adjust an intended track and to hold a specific position of the guide wire until the implant is inserted. Such devices commonly require the surgeon to extrapolate the inner bony implant path using fluoroscopy in multiple planes that inevitably results in repetitive adjustment steps and drill trials. Hence, there is a need for simple and handy tools that allow a fast and accurate position of the guide wire entry point before intramedullary nail implantation.
The present invention provides the benefits on the reduction of radiation exposure, a decrease of procedure time, as well as a significant reduction of soft tissue envelope damage by a fast and accurate placement of guide wire through entry point.